Nondietary cardiovascular health metrics with patient experience and loss of productivity among US adults without cardiovascular disease: The medical expenditure panel survey 2006 to 2015

Document Type



Office of the Provost; Cardiology


Background: The American Heart Association 2020 Impact Goals aimed to promote population health through emphasis on cardiovascular health (CVH). We examined the association between nondietary CVH metrics and patient-reported outcomes among a nationally representative sample of US adults without cardiovascular disease.
Methods and Results: We included adults aged ≥18 years who participated in the Medical Expenditure Panel Survey between 2006 and 2015. CVH metrics were scored 1 point for each of the following: not smoking, being physically active, normal body mass index, no hypertension, no diabetes mellitus, and no dyslipidemia, or 0 points if otherwise. Diet was not assessed in Medical Expenditure Panel Survey. Patient-reported outcomes were obtained by telephone survey and included questions pertaining to patient experience and health-related quality of life. Regression models were used to compare patient-reported outcomes based on CVH, adjusting for sociodemographic factors and comorbidities. There were 177 421 Medical Expenditure Panel Survey participants (mean age, 45 [17] years) representing ~187 million US adults without cardiovascular disease. About 12% (~21 million US adults) had poor CVH. Compared with individuals with optimal CVH, those with poor CVH had higher odds of reporting poor patient-provider communication (odds ratio, 1.14; 95% CI, 1.05-1.24), poor healthcare satisfaction (odds ratio, 1.15; 95% CI, 1.08-1.22), poor perception of health (odds ratio, 5.89; 95% CI, 5.35-6.49), at least 2 disability days off work (odds ratio, 1.39; 95% CI, 1.30-1.48), and lower health-related quality of life scores.
Conclusions: Among US adults without cardiovascular disease, meeting a lower number of ideal CVH metrics is associated with poor patient-reported healthcare experience, poor perception of health, and lower health-related quality of life. Preventive measures aimed at optimizing ideal CVH metrics may improve patient-reported outcomes among this population.


Pagination is not provided by the author/publisher. This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

Journal of the American Heart Association